{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T04:06:57Z","timestamp":1789186017454,"version":"build-2803163510"},"reference-count":10,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2026,10]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objectives<\/jats:title>\n High\u2010frequency recurrence of peripheral facial palsy suggests an underlying structural predisposition. We aimed to identify the anatomical phenotype associated with \u2265\u20093 recurrences using high\u2010resolution CT (HRCT).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We retrospectively analyzed 63 patients with high\u2010frequency recurrence (mean 3.5 episodes) and 62 normal controls. Four HRCT parameters were quantified: geniculate ganglion (GG) enlargement, labyrinthine segment (LS) constriction, intracanalicular bony exostosis, and greater superficial petrosal nerve (GSPN) thickening. Inter\u2010parameter correlations were also evaluated.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The mean age at the first attack was young (22.1\u2009years). Intracanalicular bony exostosis was identified as the most potent predictor of recurrence (39.7% vs. 9.7%; OR: 7.39,\n p<\/jats:italic>\n \u2009<\u20090.001). GG enlargement and GSPN thickening were significantly more prevalent in the recurrent group (\n p<\/jats:italic>\n \u2009<\u20090.01) and showed a strong positive correlation (\u03c1\u2009=\u20090.58,\n p<\/jats:italic>\n \u2009<\u20090.001), supporting a retrograde inflammatory spread mechanism. Overall, 63.5% of the recurrent group exhibited at least one structural or secondary finding (\n p<\/jats:italic>\n \u2009<\u20090.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n High\u2010frequency recurrent facial palsy is associated with a structural phenotype, where fixed bony constraints like exostosis exacerbate chronic secondary inflammatory changes in the GG and GSPN. Recognizing these features on HRCT may help predict individuals at risk for recurrence and assist in planning targeted surgical decompression.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence<\/jats:title>\n 3.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/lary.70607","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T03:01:09Z","timestamp":1778036469000},"page":"4263-4270","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Structural Phenotype of High\u2010Frequency Recurrent Facial Palsy"],"prefix":"10.1002","volume":"136","author":[{"given":"Yeso","family":"Choi","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology Hallym University College of Medicine, Dong\u2010Tan Sacred Heart Hospital Hwaseong\u2010si Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Il\u2010Seok","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Hallym University College of Medicine, Dong\u2010Tan Sacred Heart Hospital Hwaseong\u2010si Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung Jun","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Hallym University College of Medicine, Dong\u2010Tan Sacred Heart Hospital Hwaseong\u2010si Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihae","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Hallym University College of Medicine, Dong\u2010Tan Sacred Heart Hospital Hwaseong\u2010si Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6634-7750","authenticated-orcid":false,"given":"Jin","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Hallym University College of Medicine, Dong\u2010Tan Sacred Heart Hospital Hwaseong\u2010si Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,5]]},"reference":[{"key":"e_1_2_9_2_1","article-title":"Clinical Features and Prognosis of Recurrent Bell's Palsy: A Network\u2010Based Meta\u2010Analysis","volume":"13","author":"Zhang W.","year":"2022","journal-title":"Frontiers in Neurology"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.18773\/austprescr.2017.030"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002167"},{"issue":"3","key":"e_1_2_9_5_1","first-page":"754","article-title":"Morphometric Analysis of the Facial Nerve Canal Using High\u2010Resolution Computed Tomography","volume":"30","author":"Haque M. Z.","year":"2021","journal-title":"Mymensingh Medical Journal"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.571"},{"issue":"11","key":"e_1_2_9_7_1","first-page":"4135","article-title":"MRI in Facial Nerve Paralysis: When and What to Look for","volume":"278","author":"Veen M. M.","year":"2021","journal-title":"European Archives of Oto\u2010Rhino\u2010Laryngology"},{"issue":"8","key":"e_1_2_9_8_1","first-page":"1055","article-title":"Anatomical Variations of the Facial Nerve Canal in Patients With Recurrent Facial Palsy: A Systematic Review","volume":"40","author":"Zhu J.","year":"2019","journal-title":"Otology & Neurotology"},{"issue":"5","key":"e_1_2_9_9_1","first-page":"1012","article-title":"Surgical Decompression for Facial Nerve Paralysis: Long\u2010Term Outcomes and Anatomical Considerations","volume":"6","author":"Bassin B.","year":"2021","journal-title":"Laryngoscope Investig Otolaryngol"},{"issue":"2","key":"e_1_2_9_10_1","first-page":"88","article-title":"Chronic Geniculate Ganglionitis: Clinical and Radiological Features","volume":"80","author":"Vibert D.","year":"2018","journal-title":"ORL: Journal for Otorhinolaryngology and Its Related Specialties"},{"issue":"4","key":"e_1_2_9_11_1","first-page":"592","article-title":"Multi\u2010Directional Approach in Facial Nerve Decompression: Clinical Implications of Bony Irregularities","volume":"47","author":"Iwasaki S.","year":"2020","journal-title":"Auris, Nasus, Larynx"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70607","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.70607","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70607","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T03:19:39Z","timestamp":1789183179000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.70607"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,5]]},"references-count":10,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/lary.70607"],"URL":"https:\/\/doi.org\/10.1002\/lary.70607","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,5]]},"assertion":[{"value":"2026-01-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}